Biologically active compound conjugated to a stapled or stitched peptide

ABSTRACT

The invention relates to improvements in drug delivery and more particularly to the use of Cell Penetrating Agents (CPA&#39;s) or Cell Penetrating Peptides (CPP&#39;s) which have been stabilized by, for example: i) stapling two amino acids to form Stapled CPP&#39;s (StaP&#39;s) or ii) stitching three or more amino acids to form stitched CPP&#39;s (StiP&#39;s). These stabilized CPP&#39;s are conjugated to a drug or Biologically Active Compound (BAC) directly or via a Bi-Functional Linker (BFL) so that the BAC can be carried through a cell membrane by the CPP. The resulting molecules are referred to as Drug Carrying Cell Penetrating Molecules (DCCPM&#39;s). The preferred BAC is an electrically low charge carrying oligonucleotide such as a phosphorodiamidate morpholino oligonucleotide (PMO). The invention also relates to a method of facilitating the uptake of a BAC into a cell, the use of a DCCPM in the treatment of a disease requiring alteration of an endogenous or exogenous gene, a method of improving the bioavailability of a drug or BAC, a method of introducing a drug or BAC to a site which is refractory to the drug or BAC in its native state, a method of treating a subject comprising administering the DCCPM&#39;s of the invention and to a pharmaceutical composition comprising the DCCPM and one or more pharmaceutically acceptable excipients.

RELATED APPLICATION

This application is a national stage filing under 35 U.S.C. § 371 of International Patent Application Serial No. PCT/GB2016/054028, filed Dec. 21, 2016, the contents of which is incorporated herein by reference in its entirety.

REFERENCE TO A SEQUENCE LISTING SUBMITTED AS A TEXT FILE VIA EFS-WEB

This application contains a Sequence Listing which has been submitted in ASCII format via EFS-Web and is hereby incorporated by reference in its entirety. Said ASCII copy, created on May 11, 2021, is named H066470091U500-SUBSEQ-DQP and is 94,142 bytes in size.

The present invention relates to improvements in drug delivery.

More particularly it relates to the use of Cell Penetrating Agents (CPA's), and more particularly still to the use of Cell Penetrating Peptides (CPP's) which have been stabilized by, for example: i) stapling two amino acids to form Stapled CPP's (StaP's) or ii) stitching three or more amino acids to form stitched CPP's (StiP's).

These stabilized CPP's are conjugated to a drug or Biologically Active Compound (BAC) directly or via a Bi-Functional Linker (BFL) so that the BAC can be carried though a cell membrane by the CPP. The resulting molecules are referred to as Drug Carrying Cell Penetrating Molecules (DCCPM's).

The preferred BAC's delivered in this manner are oligonucleotides (ON's), more preferably still electrically low charge carrying oligonucleotides (charge −3 to +3 at pH 7.5) and most preferably electrically neutral oligonucleotides (charge −1 to +1 at pH 7.5), such as, but not limited to, polynucleic acids (PNAs), phosphorodiamidate morpholino oligonucleotides (PMO's) or modified derivatives thereof.

The preferred BFL may be PEGylated, comprising poly ethylene glycol (PEG) groups including modifications such as an amine group, or incorporate a spacer, such as 3-Ala. These modifications can improve solubilisation or provide appropriate spacing between functional moieties.

The invention also relates to a method of facilitating the uptake of a BAC into a cell, the use of a DCCPM in the treatment of a disease requiring alteration of an endogenous or exogenous gene, a method of improving the bioavailability of a drug or BAC, a method of introducing a drug or BAC to a site which is refractory to the drug or BAC in its native state, a method of treating a subject comprising administering the DCCPM's of the invention and to a pharmaceutical composition comprising the DCCPM and one or more pharmaceutically acceptable excipients.

Still further aspects will be apparent from the detailed description.

BACKGROUND TO THE INVENTION

In the treatment of all diseases it is desirable to deliver a drug or BAC into the body, and more preferably into a cell, at a target site, in a manner that ensures a maximal effect with minimal toxicity. This can be challenging.

An example of drugs or BACs which are delivered in a targeted manner are oligonucleotides (ON's), which term includes ON analogues.

ON's can target essential DNA, RNA and protein sequences and can modulate gene expression in a number of ways that includes steric blocking to suppress (i) RNA splicing, (ii) protein translation or (iii) other nucleic acid:nucleic acid or nucleic acid:protein interactions.

Specifically, the hybridisation of ON's to specific RNA sequence motifs prevents correct assembly of the spliceosome, so that it is unable to recognise the target exon(s) in the pre-mRNA and hence excludes these exon in the mature gene transcript. Exclusion of an in-frame exon can lead to a truncated yet functional gene product; exclusion of an out of frame exon results in a frame-shift of the transcript, potentially leading to a premature stop codon and a reduction in the target gene expression level.

Additionally, ON's can be designed to target 5′ translation initiation start sites of viral gene transcript(s) to prevent binding of the translational machinery. Using antisense oligonucleotides (ASO) to suppress viral translation is a well-established technology¹ and has progressed into clinical trials for viral haemorrhagic fevers such as Marburg and Ebola^(2,3).

Also, ON's can be designed to form aptamers such that the secondary and tertiary structures can bind proteins or other cellular targets thus impacting on specific gene expression levels or other cellular processes (e.g. post-translational modifications).

An advantage of steric blocking based suppression over that of siRNA/RNAi based RNase H-induction of the RNA Induced Silencing Complex is the reduced likelihood of off target side effects.

Modifications of an ON to produce a negatively charged backbone improve stability⁴⁻⁷, but these backbone chemistries e.g. 2′0-Methyl Phosphothioate analogues, elicit membrane toxicity issues, cause thrombocytopaenia and injection site problems upon clinical translation⁸, such that efficacy is prevented by toxicity issues, even when administration protocols become increasingly intermittent⁹.

Indeed WO2013/150338 and WO 2014/053622 both disclose delivering negatively charged ON's of small size (typically smaller than 1.5 KDa) by complexing them with positively charged linear or stapled peptides of equal or greater than 15 amino acids and in the range of 15-27 amino acids.

JACS, Vol 136, 2014, G J Hilnski et al, describe stapled and stitched peptides that are able to penetrate cells. Reference is made to the possibility that these peptides could be used to deliver an oligonucleotide, presumably in the same manner as disclosed in the international applications disclosed above, i.e. by complexation. There is nothing to suggest creating new entities of much larger size (greater than 1.5 KDa, through 2.5 KDa, 5 KDa, 7.5 KDa, 10 KDa, 12.5 KDa or more) by covalently linking a BAC with a CPA, optionally via a BFL and indeed, the prior methodology requires the respective components to have opposite charges to facilitate complexing.

The use of electrically low charge carrying oligonucleotides (charge −3 to +3 at pH 7.5) and most preferably electrically neutral oligonucleotides (charge −1 to +1 at pH 7.5), such as, but not limited to, polynucleic acids (PNAs), phosphorodiamidate morpholino oligonucleotides (PMO's), (covalently) conjugated directly or indirectly, using a BFL, was not apparent and indeed, limiting the charge on the ON further allows the use of smaller peptides (less than 15 amino acids in length, through 14, 13, 12, 11, 10, 9, 8, 7, 6 to as few as 4 or 5) as carriers.

The use of uncharged ON backbones, such as phosphorodiamidate morpholino oligonucleotides (PMOs), represent attractive BAC's as they have an impeccable safety record in a preclinical and clinical setting.^(2,10-13)

However, their ability to penetrate cells and access their targets is compromised due to their uncharged nature¹⁴.

Overcoming the problem of facilitating their entry into cells is therefore desirable.

Over the last 20 years much research has been dedicated to developing CPA's that facilitate delivery of drugs and BAC's to the biological site of action.

The approach has generally been to use charged peptides as non-covalent complexes to facilitate cell entry of a BAC. Conjugation has also been tried.

WO2014/064258 is an example of the existing conjugating art. A negatively charged ON is coupled to a targeting peptide via a linker. The targeting peptide is a receptor targeting moiety, and not a stapled or stitched peptide, and indeed considerable doubt exists as to whether DNA or RNA molecules can gain cell entry using a receptor targeting moiety as once a negatively charged ON is bound to such a moiety, non-covalent interactions alter its conformation¹⁵.

WO89/03849 discloses oligonucleotide-polyamide conjugates. There is no disclosure of the use of stitched or stapled peptides. The methodology described uses oligonucleotides as a scaffold for the chain extension of peptides and not as a conjugate for delivery, per se.

WO2011/131693 describes nucleic acid constructs which contain a nucleic acid specific for a given target gene and a selective inhibitor of a neurotransmitter transporter. There is no disclosure of the use of stitched or stapled peptides as a delivery agent.

A peptide capable of effecting peptide-mediated cell delivery may also be referred to as a Cell Delivery Peptide (CDP). Examples include: poly arginine, penetratin (based upon an antennapedia homeodomain), or PMO internalization peptides (PIPs).

However, since their first description¹⁶ and given that many CPPs contain multiple arginines, β-alanine and 6-aminohexanoic acid residues, (e.g. poly-Arg12, TAT, Penetratin, Pip6a) [database maintained at crdd.osdd.net/raghava/cppsite/¹⁷, it is surprising that no CPP-delivered drug has progressed through all phases of clinical trials. In part, this may be because the common arginine-rich core, which makes most CPP's effective, also causes membrane deformities¹⁸ and in higher mammals this manifests as prohibitive toxic side effects, such as tubular degeneration of the kidney¹⁹.

At a physiological pH, and based on pKa of amino acid R groups, a formal charge (FC) can be calculated based on the formula:

${FC} = {V - N - \frac{B}{2}}$

Where, V=valence electrons of the neutral atom in isolation; N=the number of non-bonding valence electrons on the defined atom; B=the total number of electrons shared in bonds.

Indeed, based on this, the CPPs typically used to date harbour many positively charged residues. It has been shown that there is a correlation between this positive charge and membrane toxicity²⁰.

Therefore, CPPs with a lower amount of positively charged residues within the amino acid sequence, whilst retaining the ability to cross a biological membrane, will be more clinically relevant.

The Applicant has overcome this major impediment by utilising stabilized CPA's. By linking a drug or BAC to a stabilized CPA, including stitched and stapled peptides, they have surprisingly obtained enhanced cellular uptake dynamics, 10-20 fold better than current state of the art for CPA^(21,22).

They have illustrated this by delivering an ON targeted to repair a gene producing dystrophin. Targeting specific genes with ON is of course in itself known, as illustrated by, for example, WO2009/054725 and WO2010/123369. These publications however use a negatively charged backbone and deliver the cargo directly or using complexation.

One way to prepare stapled and stitched peptides, two linked amino acids (stapled) or three or more linked amino acids (stitched), is to incorporate amino acids into the peptide that are modified to bear e.g. an olefin (alkene) group (which may be incorporated at defined relative positions during solid-phase peptide synthesis). For example, on-resin ring-closing metathesis is then used to close one (stapled [denoted as StaP herein]) or two or more (stitched [denoted as StiP herein]) all-hydrocarbon cross-links that induce the peptide to adopt a stabilised structure, typically, but not essentially an alpha helix. For StaP's, it is preferred to use either one or both enantiomers of the un-natural amino acids, termed the S5 (S-pentenylalanine) or R5 (R-pentenylalanine), or the S8 (S-octenylalanine) or R8 (R-octenylalanine), depending on the stereo-chemical configuration. For StiP's, a further un-natural olefin-bearing α,α-di-substituted amino acid (B5 or B8) is utilised. Cross linking strategies are however not restricted to ring-closing metathesis of un-natural olefin-bearing α,α-di-substituted amino acids. Other cross-linking chemistry's may be used to stabilize the peptide, such as ring-closing metathesis between O-allylserine analogues (S-OAS or R-OAS).

The cellular entry dynamics of existing CPAs and the StiP's and StaP's differ. Traditional CPPs enter cells via energy-independent direct plasma membrane translocation or via energy-dependent, clathrin and caveolin-mediated endocytosis; whereas the StiP's and StaP's utilised in the invention enter via an energy dependent, but clathrin and caveolin independent mechanism^(21,23). Given that StiP's and StaP's uptake is abrogated with reduced cellular decoration of heparin sulphate²¹ a macropinocytotic entry mechanism is infered²⁴, suggesting this altered entry mechanism enables enhanced cellular uptake and bio-distribution compared to the state of the art.

Relative to their unmodified peptide precursors, StaP's and StiP's generally exhibit robust cellular uptake, significant resistance to proteolytic degradation, and in vivo stability that can support a half-life of more than 12 hours in non-human primates²⁵. It is likely that this increase in drug-likeness stems from the highly rigidified structure and the burial of the backbone amide bonds in the core of e.g. the α-helix. This structural rigidity also decreases the likelihood that StiP's and StaP's will be immunogenic, as the design of major histocompatibility complexes is such that peptides must adopt an extended conformation to be presented. The potential reduced or lack of membrane toxicity and immunogenicity enhances the clinical translatability of compounds when conjugated to drugs and BAC's such as ON's.

The BAC and CPP can be covalently conjugated directly, or covalently conjugated via a BFL. Many functional groups may be used for conjugation reactions.

ONs can be used to induce a steric block to any gene in humans, animals and lower order organisms and thus can be applied to natural disease (including genetic and age-related diseases) or acquired diseases in humans and animals.

For example, viral haemorrhagic fevers (VHFs) are animal-borne illnesses in which a prolonged inflammatory cytokine response leads to the gradual destruction of veins and arteries. Causes of VHF include Ebola and Marburg viruses and several Arena viruses; these diseases are presently considered untreatable. Viral haemorrhagic fevers are characterized by high fever and bleeding disorders, and can cause death by shock and organ failure. ASOs can be designed to target 5′ translation initiation start sites of viral gene transcript(s) to prevent binding of the translational machinery. Using ASO to suppress viral translation is a well-established technology¹ and has progressed into clinical trials for viral haemorrhagic fevers such as Marburg and Ebola^(2,3). One PMO, AVI-7537 was evaluated for human use in the West African Ebola outbreak in 2014-15.

Some tissues are particularly refractory to naked PMO transfection, e.g. heart, which may reflect differential vesicle-mediated PMO uptake mechanisms²³. In fact, direct intra-cardiac injection of naked PMO does not even lead to efficient transfection²⁶, and refractory tissues tend to require repeat administration or high dose strategies²⁷⁻²³. However, whilst CPP conjugation improves PMO bio-distribution and serum stability³⁶⁻³², toxicity is still a major roadblock for pipeline development¹⁹.

For effective clinical translation of steric blocking ASOs, CPPs need to effectively deliver the BAC to either the cytoplasm or nucleoplasm whilst limiting any toxicity associated with cell entry.

Thus, providing DCCPM's which are able to deliver a drug or BAC more efficiently or to a target site, or with lower toxicity and immunogenicity would be highly desirable.

BRIEF SUMMARY OF THE DISCLOSURE

In accordance with a first aspect of the present invention there is provided a drug carrying cell penetrating molecule (DCCPM) comprising:

-   -   i. a biologically active compound (BAC), and     -   ii. a cell penetrating agent (CPA), which BAC and CPA are linked         directly or via a bi-functional linker (BFL),     -   and wherein the CPA is a stabilized peptide (CPP) which has a         conformation imposed upon it by stapling to form a stapled         peptide (StaP) or stitching to form a stitched peptide (StiP).

A stapled peptide (StaP) may be formed by, for example, stapling two conformationally adjacent amino acids together, and a stitched peptide (StiP) may be formed by, for example, stitching at least three conformationally adjacent amino acids to form a stitched peptide (StiP).

The stapling or stitching results in the formation of a cross link or bridge between two conformationally adjacent amino acids of the peptide.

In a preferred embodiment the cross link or bridge comprises two components, a hydrocarbon bridge and a terminal methyl group. The hydrocarbon bridge may be composed of a double hydrocarbon bond or a single hydrocarbon bond.

The CPP preferably comprises at least two un-natural amino acids bearing all-hydrocarbon tethers (e.g. α-methyl, α-pentenyl glycine).

The preferred stapled or stitched CPPs incorporate one or more of: a (S)-pentenylalanine (S5) or its enantiomer (R5), a S-octenylalanine (S8) or its enantiomer (R8) or combinations thereof (e.g. R-octenylalanine/S-pentenylalanine (R8/S5) or S-octenylalanine/R-pentenylalanine (S8/R5).

The preferred unnatural amino acids incorporated into the CPPs and reacted to form a cross link or bridge between them are illustrated in Table 1 and some exemplary and preferred resulting CPPs are illustrated in Table 2.

TABLE 1 Unnatural Amino Acids

TABLE 2 Entry Peptide Sequence Length Peptide Type 3 TRQARRNRRRRWRRAAAA 18 Non RCM 4 TRQARRNRRRRWRERQR 17 Non RCM 5 RQIKIWFQNRRMKWKK 16 Non RCM 6 RRRRRRRRWRRR 12 Non RCM 7 LSQETFSDLWKLLPEN 16 Non RCM 8 NQLKRSFFALRDQI 14 Non RCM 8 NQLKRSFFALRDQI 14 Non RCM 9 TILKASVDYIRKLQREQQRAKEL 23 Non RCM 6 RRRRRRRRWRRR 12 Non RCM 10 RRRRRRRRRRRR 12 Non RCM 11 YGRKKRRQRRRP 12 Non RCM 12 RKFKRLFQ  8 Non RCM 13 NELKRSFFALRDQI 14 Non RCM 14 NQL-R8-RS-FFAL-S5-DQI 14 Non RCM 15 KNHTHQQDI  9 Non RCM  16 NELKRSFFALRDQIPSLQGEKASRAQILDKA 42 Non RCM TEYIQYNLRRK  17 KATEYIQYNLRRKNHTHQQDIDDL 24 Non RCM 18 ASTLFETFYLGGLLG 15 Non RCM 19 RRGSRPSGA-S5-RRR-S5-R 15 Non RCM 20 FNINDRIKELGTLI 14 Non RCM 21 DHIKDSFHSLRDSVPSLQGEKASRAQILDK 42 Non RCM ATEYIQYNLRRK 22 EYIQYNLRKNHTHQQDIDDLKRQNALLEQQ 36 Non RCM VRALGG 23 SSLFERFYNLVTPAGG 16 Non RCM 24 NSSFADFFHTVPYNLL 16 Non RCM 25 TRQARRN-S5-RRR-S5-RR 14 Non RCM 26 RRGSRPSGA-S5-RRR-S5-RAAAA 19 i, i + 4 Staple 27 S5-RRQ-S5-RRDRQRRRRR 15 i, i + 4 Staple 28 TRQ-S5-RRQ-S5-RRRWRERQR 17 i, i + 4 Staple 29 SEELV-S5-EAH-S5-LCTLLENAIQDTVREQ 26 i, i + 4 Staple 30 SEELVAEAH-S5-LCT-S5-LENAIQDTVREQ 26 i, i + 4 Staple 31 SEELVAEAHNLCTLLE-S5-AIQ-S5-TVREQ 26 i, i + 4 Staple 32 DRRQRRR-S5-RQR-S5-RRR 15 i, i + 4 Staple 33 S5-RRQ-S5-RRRRQRRRRR 15 i, i + 4 Staple 34 S-S5-ELV-S5-EAHNLCTLLENAIQDTVREQ 26 i, i + 4 Staple 35 SEELVAEA-S5-NLC-S5-LLENAIQDTVREQ 26 i, i + 4 Staple 36 SEELVAEAHNLC-S5-LLE-S5-AIQDTVREQ 26 i, i + 4 Staple 37 SEELVAEAHNLCTLLENAI-S5-DTV-S5-EQ 26 i, i + 4 Staple 38 FS-S5-LWK-S5-L  8 i, i + 4 Staple 39 FM-S5-YWK-S5-L  8 i, i + 4 Staple 40 QTFS-S5-LWK-S5-L 10 i, i + 4 Staple 41 PPKKFR-S5-LFF-S5-S 12 i, i + 4 Staple 42 KK-pff-R-S5-LFF-S5-S 10 i, i + 4 Staple 43 RK-pff-S5-RLF-S5-SY 10 i, i + 4 Staple 44 RKF-S5-RLF-S5-SY 10 i, i + 4 Staple 45 R-pff-K-S5-RLF-S5-SY 10 i, i + 4 Staple 46 AM-S5-YVVK-S5-L  8 i, i + 4 Staple 47 QTFSD-R5-WK-S5-L 10 i, i + 4 Staple 48 KKFR-S5-LFF-S5-S 10 i, i + 4 Staple 49 RRLFR-S5-NLFL-S5-T 12 i, i + 4 Staple 50 RR-pff-S5-RLF-S5-SY 10 i, i + 4 Staple 51 RKA-S5-RLF-S5-SY 10 i, i + 4 Staple 43 RK-pff-S5-RLF-S5-SY 10 i, i + 4 Staple 52 S5-RLF-S5-SY  7 i, i + 4 Staple 53 KQKRKFS-S5-FFK-S5-L 13 i, i + 4 Staple 54 KQKRK-pff-S-S5-FFK-S5-L 13 i, i + 4 Staple 54 KQKRK-pff-S-S5-FFK-S5-L 13 i, i + 4 Staple 55 KF-S5-RLF-S5  7 i, i + 4 Staple 56 S5-RLF-S5  5 i, i + 4 Staple 57 RKF-S5-RLF-S5  8 i, i + 4 Staple 58 KQKRKFS-S5-FFK-S5-LV 13 i, i + 4 Staple 59 KQ-pff-RKKS-S5-FFK-S5-L 13 i, i + 4 Staple 60 RK-pff-S5-RLF-S5  8 i, i + 4 Staple 61 F-S5-RLF-S5  6 i, i + 4 Staple 62 KTYRGAFQ-S5-LFQ-S5-VRE 16 i, i + 4 Staple 63 STALR-S5-LIE-S5-LVNITQNQKAPL 22 i, i + 4 Staple 64 STALRELI-S5-ELV-S5-ITQNQKAPL 22 i, i + 4 Staple 65 STALRELIEEL-S5-NIT-S5-NQKAPL 22 i, i + 4 Staple 66 NELK-S5-SFF-S5-LRDQIPELENNEKAP 24 i, i + 4 Staple 67 LENRQ-S5-KLE-S5-ANRHLL 16 i, i + 4 Staple 68 IL-S5-ASV-S5-YIRKLQREQ 16 i, i + 4 Staple 69 FNI-S5-DRI-S5-ELGTLI 14 i, i + 4 Staple 70 KN-S5-THQ-S5-DI  9 i, i + 4 Staple 71 STALRELIEE LV-S5-ITQ-S5-QKAPL 21 i, i + 4 Staple 72 NELK-S5-SFF-S5-LRDQI 14 i, i + 4 Staple 73 LENRQKKLE-S5-ANR-S5-LL 16 i, i + 4 Staple 74 ILKAS-S5-DYI-S5-KLQREQ 16 i, i + 4 Staple 75 DHIK-S5-SFH-S5-LRDSV 14 i, i + 4 Staple 76 DHIKDSF-S5-SLR-S5-SV 14 i, i + 4 Staple 77 S5-Y1Q-S5- 38 i, i + 4 Staple NLRRKNHTHQQDIDDLLKRQNALLEQQVR ALGG 78 TYRGAAQ-S5-AAQ-S5-VREV 16 i, i + 4 Staple 79 TY-S5-GAF-S5-NLFQSVREV 16 i, i + 4 Staple 80 A-S5-SVF-S5-NYFHSVPYFEL 17 i, i + 4 Staple 81 GAF-S5-NLF-S5-SV 10 i, i + 4 Staple 82 S5-GAF-S5-NLF-R5-SV 11 i, i + 4 Staple 83 SYRGAFQ-S5-LFQ-S5-VREV 16 i, i + 4 Staple 84 SSVFY-S5-YFH-S5-VPYFEL 16 i, i + 4 Staple 85 A-S5-TLF-S5-TFYLGGLLG 15 i, i + 4 Staple 86 S5-GAF-S5-NLFQSV 11 i, i + 4 Staple 87 A-S5-SSF-S5-DFFHTVPYNLL 17 i, i + 4 Staple 88 ERLRRRI-S5-LCR-S5-HHST 16 i, i + 4 Staple 89 ERLRRRI-S5-NLCR-S5-HHST 17 i, i + 4 Staple 90 ERLRRRL-S5-LCR-S5-HHST 16 i, i + 4 Staple 91 ERLRRRF-S5-LCR-S5-HHST 16 i, i + 4 Staple 92 ERFRRRI-S5-LCR-S5-HHST 16 i, i + 4 Staple 93 ERLARRI-S5-LCR-S5-HHST 16 i, i + 4 Staple 94 ENPESILD-S5-HVQ-S5-VM 15 i, i + 4 Staple 95 PE-S5-ILD-S5-HVQRVM 13 i, i + 4 Staple 96 ERLRRRI-S5-FCR-S5-HHST 16 i, i + 4 Staple 97 ERLRRRNL-S5-LCR-S5-HHST 17 i, i + 4 Staple 98 ERNLRRRI-S5-LCR-S5-HHST 17 i, i + 4 Staple 99 ERWRRRI-55-LCR-55-HHST 16 i, i + 4 Staple 100 RELRREI-S5-LCR-S5-HHST 16 i, i + 4 Staple 101 ENPE-S5-ILD-S5-HVQRVM 15 i, i + 4 Staple 102 NPE-S5-ILD-S5-HVQRVM 14 i, i + 4 Staple 103 WPE-S5-ILD-S5-HVQRVM 14 i, i + 4 Staple 104 PE-S5-ILD-S5-HVRRVMR 14 i, i + 4 Staple 105 RPE-S5-ILD-S5-HVRRVMR 15 i, i + 4 Staple 106 TRQA-R8-RNRRRR-S5-RR 14 i, i + 7 Staple 107 RRGSRPSGA-R8-RRRRRA-S5 17 i, i + 7 Staple 108 RRGSRPSGA-R8-RRRRRA-S5-AA 19 i, i + 7 Staple 109 TRQARRN-R8-RRRWRE-S5-QR 17 i, i + 7 Staple 110 RRRR-R5-RRRWRR-S8 12 i, i + 7 Staple 111 KPE-S5-ILD-S5-HVQRVM 14 i, i + 7 Staple 112 WPE-S5-ILD-S5-HVRRVMR 15 i, i + 7 Staple 113 RRRR-R8-RQRRRR-S5-RR 14 i, i + 7 Staple 114 RRGSRPSGA-R8-RRRRRR-S5 17 i, i + 7 Staple 115 R8-RRQRRR-S5-RQRRRRR 15 i, i + 7 Staple 109 TRQARRN-R5-RRRWRE-S8-QR 17 i, i + 7 Staple 116 RRRR-R5-RRRRRR-S8 12 i, i + 7 Staple 117 YGRK-R5-RRQRRR-S8 12 i, i + 7 Staple 118 S-R8-ELVAEA-S5-NLCTLLENAIQDTVREQ 25 i, i + 7 Staple 119 SEELVAEAH-R8-LCTLLE-S5-AIQDTVREQ 26 i, i + 7 Staple 120 SEELVAEAHNLCT-R8-LENAIQ-S5-TVREQ 26 i, i + 7 Staple 121 RQIKIW-R5-QNRRMK-S8-KK 16 i, i + 7 Staple 110 RRRR-R5-RRRWRR-S8 12 i, i + 7 Staple 118 S-R8-ELVAEA-S5-NLCTLLENAIQDTVREQ 26 i, i + 7 Staple 122 SE-R8-LVAEAH-S5-LCTLLENAIQDTVREQ 26 i, i + 7 Staple 123 SEELVAEAHNLC-R8-LLENAI-S5-DTVREQ 26 i, i + 7 Staple 124 SEELVAEAHNLCTLLE-R8-AIQDT V-S5-EQ 26 i, i + 7 Staple 125 LSQETF-R8-DLWKLL-S5-EN 16 i, i + 7 Staple 126 ILR-R8-AVSHMK-S5-LRGT 15 i, i + 7 Staple 126 ILR-R8-AVSHMK-S5-LRGT 15 i, i + 7 Staple 127 NEL-R8-RS FRSL-S5-DSI 14 i, i + 7 Staple 128 NEL-R8-RS FRAL-S5-DQI 14 i, i + 7 Staple 129 NEL-R8-RS FFAL-S5-DSI 14 i, i + 7 Staple 130 NEL-R8-RS FFAL-S5-DQI 14 i, i + 7 Staple 131 IL-R8-MA-VSHM-S5-SLRGT 15 i, i + 7 Staple 132 NEL-R8-RS FRAL-S5-DSI 14 i, i + 7 Staple 133 NEL-R8-RS FFSL-S5-DQI 14 i, i + 7 Staple 134 WNEL-R8-RSFRSL-S5-DQI 15 i, i + 7 Staple 135 NQR-R8-LSFFAL-S5-DQI 14 i, i + 7 Staple 14 NQL-R8-RSFFAL-S5-DQI 14 i, i + 7 Staple 135 NQR-R8-LSFFAL-S5-DQI 14 i, i + 7 Staple 136 NQL-R8-LSFFAR-S5-DQI 14 i, i + 7 Staple 137 NKL-R8-RS FFAL-S5-DQI 14 i, i + 7 Staple 130 NEL-R8-RS FFAL-S5-DQI 14 i, i + 7 Staple 138 NELK-R8-SFFALR-S5-QIPELENNEKAP 24 i, i + 7 Staple 139 AHL-R8-LCLEKL-S5-GLV 14 i, i + 7 Staple 14 NQL-R8-RSFFAL-S5-DQI (D-amino acids) 14 i, i + 7 Staple 191 IQD-S5-LAFFSR-R8-LQN (D-amino acids) 14 i, i + 7 Staple 140 NKL-R8-RS-FKAL-S5-KQI 14 i, i + 7 Staple 141 NELK-R8-S-FFALR-S5-QI 14 i, i + 7 Staple 142 NQL-R8-RS-FFAL-S5-DQIPELENNEKAP 24 i, i + 7 Staple 14 NQL-R8-RSFFAL-S5-DQI 14 i, i + 7 Staple 192 AHL-R8-LCLEKL-S5-GLV-(K-(PEG)1- 15 i, i + 7 Staple 143 KV-R8-ILK KAT-S5-YILS 14 i, i + 7 Staple 144 R8-KR RAHA-S5-AERARR 14 i, i + 7 Staple 191 IQD-S5-LAFFSR-R8-LQN (D-amino acids) 14 i, i + 7 Staple 14 NQL-R8-RSFFAL-S5-DQI (D-amino acids) 14 i, i + 7 Staple 14 NQL-R8-RS-FFAL-S5-DQI 14 i, i + 7 Staple 14 NQL-R8-RSFFAL-S5-DQI 14 i, i + 7 Staple 145 EENAKRR-R8-HNALER-S5-RR 17 i, i + 7 Staple 193 NQL-R8-FSRFAL-S5-DQI (D-amino acids) 14 i, i + 7 Staple 146 NQL-R8-LS-S5-DQI 10 i, i + 7 Staple 147 NQL-R8-FS-S5-DQI 10 i, i + 7 Staple 148 TILKASVDYIRKL-R8-REQQRA-S5-EL 23 i, i + 7 Staple 149 FNI-R8-DRI-S5-TLI 11 i, i + 7 Staple 150 RNI-R8-DRI-S5-TRI 11 i, i + 7 Staple 151 KATEYIQYNLRRKN-R8-THQQDI-S5-DL 24 i, i + 7 Staple 152 NEL-R8-RSFFAL-S5-DQIDQIPAAKRVKLD 26 i, i + 7 Staple 14 NQL-R8-RSFFAL-S5-DQI 14 i, i + 7 Staple 153 RNI-R8-DRIKEL-S5-TLI 14 i, i + 7 Staple 154 FNIN-R8-RIKELG-S5-LI 14 i, i + 7 Staple 155 FNI-R8-DRIKEL-S5-TRI 14 i, i + 7 Staple 156 NQL-R8-RSFRAL-S5-DQI 15 i, i + 7 Staple 157 NEL-R8-RSFFAL-S5-DQIDQIPKKKRKV 24 i, i + 7 Staple 158 ENPE-R8-ILDEHV-S5-RVM 15 i, i + 7 Staple 164 S8-RQARRN-B5-RRRWRE-S8-QR 16 i, i + 4, i + 11 Stitch Reduced 163 TRQ-S5-RRN-B5-RRRWRE-S8-QR 17 i, i + 4, i + 11 Stitch 159 TRQ-S5-RRA-B5-RRRWRE-S8-QR 17 i, i + 4, i + 11 Stitch 160 S5-RRN-B5-RRRWRE-S8 12 i, i + 4, i + 11 Stitch 161 EY1Q-R5-NLRRKNH-S8-HQQDIDDLKRQNALLEQQVRALGG 37 i, i + 4, i + 11 Stitch 165 S8-RQARRQ-B5-RRRWRE-S8-QR 17 i, i + 4, i + 11 Stitch Reduced 162 TRQ-S5-Q-B5-RRRWRE-S8-QR 15 i, i + 4, i + 11 Stitch 163 TRQ-S5-RRN-B5-RRRWRE-S8-QR 17 i, i + 4, i + 11 Stitch Reduced 164 R8-RQARRN-B5-RRRWRE-S8-QR 17 i, i + 4, i + 11 Stitch Reduced 165 R8-RQARRQ-B5-RRRWRE-S8-QR 17 i, i + 4, i + 11 Stitch 166 S5-RRN-B5-RRRWRR-S8 12 i, i + 4, i + 11 Stitch 167 RRA-B5-RRRWRR-S8 11 i, i + 4, i + 11 Stitch 169 S5-RRR-B5-RRRRRR-S8 12 i, i + 4, i + 11 Stitch 168 S5-KIW-B5-QNRRNLK-S8 13 i, i + 4, i + 11 Stitch 169 S5-RRR-B5-RRRRRR-S8 12 i, i + 4, i + 11 Stitch 170 S5-GRK-B5-RRQRRR-S8 12 i, i + 4, i + 11 Stitch 171 S5-RRQ-B5-RRRWRR-S8 12 i, i + 4, i + 11 Stitch 174 S5-RRR-B5-RRRWRR-S8 12 i, i + 4, i + 11 Stitch 172 RQ-S5-KIW-B5-QNRRMK-S8-KK 16 i, i + 4, i + 11 Stitch 173 S5-KIW-B5-QNRRAK-S8 12 i, i + 4, i + 11 Stitch 174 S5-RRR-B5-RRRWRR-S8 12 i, i + 4, i + 11 Stitch 175 L-S5-ILQ-B5-AVQVIL-S8-LEQQVRER 21 i, i + 4, i + 11 Stitch 176 LLILQQAV-S5-VIL-B5-LEQQVR-S8-R 21 i, i + 4, i + 11 Stitch 182 S5-DFS-B5-YWK-R5-L 10 i, i + 4, i + 11 Stitch 177 LS-S5-ETF-B8-DLWKLL-S8-EN 16 i, i + 4, i + 11 Stitch 178 LSQ-S5-TFS-B8-LWKLLA-S8-N 16 i, i + 4, i + 11 Stitch 179 L-S5-ILQ-B5-AVQ-R5-ILGLEQQVRER 21 i, i + 4, i + 11 Stitch 180 LLILQQAV-S5-VIL-B5-LEQ-R5-VRER 21 i, i + 4, i + 11 Stitch 181 LLIL-S5-QAV-B5-VIL-R5-LEQQVRER 21 i, i + 4, i + 11 Stitch 182 R5-DFS-B5-YVVK-S5-L 10 i, i + 4, i + 11 Stitch 183 LS-S5-ETA-B8-DLWKLL-S8-EN 16 i, i + 4, i + 11 Stitch 184 EDIIRNIA-S5-HLA-B5-VGDWNLD-S8-SI 23 i, i + 4, i + 11 Stitch 185 NIA-S5-HLA-B5-VGDWNLD-S8-SI (isomer 2) 18 i, i + 4, i + 11 Stitch 186 S5-HLA-B5-VGDWNLD-S8 (isomer 1) 13 i, i + 4, i + 11 Stitch 187 NVKRR-R8-HNVLER-S5-RRNEL-R8-RSFFAL-S5-DQI 29 i, i + 4, i + 11 Stitch 188 S5-Y1Q-B5-NLRRKNH-S8- 38 i, i + 4, i + 11 Stitch HQQDIDDLLKRQNALLEQQVRALGG 185 NIA-S5-HLA-B5-VGDWNLD-S8-SI 18 i, i + 4, i + 11 Stitch 189 NIA-S5-HLA-B5-VGDWNLD-S8 16 i, i + 4, i + 11 Stitch 186 S5-HLA-B5-VGDWNLD-S8 13 i, i + 4, i + 11 Stitch 190 EYIQYNLR-S5-KNH-B5-HQQDID-S8- 37 i, i + 4, i + 11 Stitch LKRQNALLEQQVRALGG S5 = a-methyl, a-alkenylglycine with 5 carbon chain S8 = a-methyl, a-alkenylglycine with 8 carbon chain B5 = a-methyl, a-alkenylglycine with two 5 carbon chain

Alternative CPPs and their method of manufacture are disclosed in Chu et al, 2014 and associated supplementary information, and are incorporated by reference²¹.

The exemplified stabilized peptide comprises two or more olefin bearing side chains that are covalently formed, typically by means of a ring-closing metathesis.

The stabilized conformation typically comprises at least one alpha helix. It may however, in the alternative, comprise at least one turn (for example, but not limited to, α, β, γ, δ or π), several turns to form a beta sheet, or a combination of one or more of: an alpha helix, turn, or beta sheet.

The formal charge of a CPP is calculated at physiological pH (about 7.5) and is based on the pKa of amino acid R groups. These values (pK_(x)) are represented in Table 3.

TABLE 3 Residue 3-Letter 1-Letter Molecular Molecular Residue Weight Name Symbol Symbol Weight Formula Formula (—H₂O) pKa1 pKb2 pKx3 pI4 Alganine Ala A 89.10 C₃H₇NO₂ C₃H₅NO 71.08 2.34 9.69 — 6.00 Arginine Arg R 174.20 C₆H₁₄N₄O₂ C₆H₁₂N₄O 156.19 2.17 9.04 12.48 10.76 Asparagine Asn N 132.12 C₄H₈N₂O₃ C₄H₆N₂O₂ 114.11 2.02 8.80 — 5.41 Aspartic Acid Asp D 133.11 C₄H₇NO₄ C₄H₅NO₃ 115.09 1.88 9.60 3.65 2.77 Cysteine Cys C 121.16 C₃H₇NO₂S C₃H₅NOS 103.15 1.96 10.28 8.18 5.07 Glutamic acid Glu E 147.13 C₅H₉NO₄ C₅H₇NO₃ 129.12 2.19 9.67 4.25 3.22 Glutamine Gln Q 146.15 C₅H₁₀N₂O₃ C₅H₈N₂O₂ 128.13 2.17 9.13 — 5.65 Glycine Gly G 75.07 C₂H₅NO₂ C₂H₃NO 57.05 2.34 9.60 — 5.97 Histidine His H 155.16 C₆H₉N₃O₂ C₆H₇N₃O 137.14 1.82 9.17 6.00 7.59 Hydroxyproline Hyp O 131.13 C₅H₉NO₃ C₅H₇NO₂ 113.11 1.82 9.65 — — Isoleucine Ile I 131.18 C₆H₁₃NO₂ C₆H₁₁NO 113.16 2.36 9.60 — 6.02 Leucine Leu L 131.18 C₆H₁₃NO₂ C₆H₁₁NO 113.16 2.36 9.60 — 5.98 Lysine Lys K 146.19 C₆H₁₄N₂O₂ C₆H₁₂N₂O 128.18 2.18 8.95 10.53 9.74 Methionine Met M 149.21 C₅H₁₁NO₂S C₅H₁₁NOS 131.20 2.28 9.21 — 5.74 Phenylalanine Phe F 165.19 C₉H₁₁NO₂ C₉H₉NO 147.18 1.83 9.13 — 5.48 Proline Pro P 115.13 C₅H₉NO₂ C₅H₇NO 97.12 1.99 10.60 — 6.30 Pyroglutamatic Glp U 139.11 C₅H₇NO₃ C₅H₅NO₂ 121.09 — — — 5.68 Serine Ser S 105.09 C₃H₇NO₃ C₃H₅NO₂ 87.08 2.21 9.15 — 5.68 Threonine Thr T 119.12 C₄H₉NO₃ C₄H₇NO₂ 101.11 2.09 9.10 — 5.60 Tryptophan Trp W 204.23 C₁₁H₁₂N₂O₂ C₁₁H₁₀N₂O 186.22 2.83 9.39 — 5.89 Tyrosine Tyr Y 181.19 C₉H₁₁NO₃ C₉H₉NO₂ 163.18 2.20 9.11 10.07 5.66 Valine Val V 117.15 C₅H₁₁NO₂ C₅H₉NO 99.13 2.32 9.62 — 5.96 1pKa is the negative of the logarithm of the dissociated constant for the-COOH group 2pKb is the negative of the logarithm of the dissociated constant for the-NH₃ ⁺ group 3pKx is the negative of the logarithm of the dissociated constant for any other group in the molecule 4pI is the pH at the isoelectric point References: D. R. Lide, Handbook of Chemistry and Physics, 72nd Edition, CRC Press, Boca Raton, FL, 1991.

CPPs typically used to date harbour many positively charged residues. Reducing the amount of positively charged residues within the amino acid sequence, whilst retaining the ability to cross a biological membrane, will be more clinically relevant.

Accordingly, it is possible to reduce the charge on the peptide sequences illustrated in Table 2.

The preferred BAC is an oligonucleotide (ON), more preferably still an anti-sense oligonucleotide (AON). Different anti-sense oligonucleotide chemistries are illustrated in Table 4, with the use of low charge or neutral charged chemistries, such as, phosphorodiamidate morpholino oligonucleotides (PMOs) being preferred.

TABLE 4

The BAC may target and alter the expression of an endogenous or exogenous gene. Endogenous gene targets include but are not limited to genes associated with neuromuscular disease, metabolic disease, cancer, age-related degenerative diseases, and exogenous gene targets include those of an acquired disease e.g. viral infections.

Whilst the BAC may be linked to the CPP directly the Applicant has found the use of a BFL desirable. Exemplary, non-limiting BFL chemistries are illustrated in Table 5.

TABLE 5 Linker acryonym Entry Linker (L) is present Z Y₃ 1

SMCC

2

AMAS

3

BMPS

4

GMPS

5

DMVS

6

EMCS

7

LC- SMCC

8

SM(PEG)_(n)

9

DSG Not present

10

DSCDS Not present

11

HNA Not present

By way of a footnote to Table 5, the following should be noted:

FIG. 5A highlights general structure of a DCCPM where the following are preferred, but not limited to the following defined atoms or groups.

In a preferred embodiment illustrated in FIG. 5C, where Y1=Nitrogen, Y2=Hydrogen, Y3=spacer such as (PEG)n n=5, but not limited to those identified in Table 5, Z=a sulfur containing moiety e.g. Cysteine and L=BFL such as SMCC

Other embodiments may utilize variations over the structure shown in FIG. 5A. For example if another embodiment does not require a thiol for conjugation of the BFL to the CPA as illustrated in FIG. 5D, then Z=Y3 where Y3 is a spacer in Table 5. For a BFL that does not require a sulphur for conjugation of the BAC and CPA e.g. not limited to entries 9-11 in Table 5 Z=a covalent bond between L and Y3

Other embodiments may not require the use of a spacer, a BFL and as such a thiol group for the formation of a DCCPM depicted in FIG. 7 then the following apply. If no spacer is utilized then Y3 can represent a covalent bond between Y1 and the BAC in which case Z and L=Y1 where Y1 is a N terminus of the CPA.

These chemistries may be further expanded and Table 6 exemplifies modifications to amino acids via which functional groups can be introduced to provide desirable properties to the DCCPM. These will include, but are not limited to, an acetyl, a cholesterol, a fatty acid, a polyethylene glycol, a polysaccharide, an aminoglycan, a glycolipid, a polyphenol, a nuclear localising signal, a nuclear export signal, an antibody, and a targeting molecule.

TABLE 6 Functional Reacting Functional Resulting group (X) Group (X)¹ Functional Group Aldehyde Hydrazine Hydrazone

Thiol Maleimides Thioether

Thiol Thiol Disulfide

Alkyne Azide Triazole

Amine Carboxylic acid Amide

Diazirine Any Various

Olefin Olefin Olefin

Aryl or Olefin Halide R—M R₂—X R—R₂

A preferred linker chemistry utilises an amine to sulphydryl cross linker containing N-hydroxysuccinimide esters and malemide reactive groups separated by a cyclohexane spacer namely succinimidyl 4-(N-maleimidomethyl) cyclohexane-1-carboxylate (SMCC) to form a covalent bond between the BFL and the CPP.

A schematic intermediate compound using SMCC as the BFL and the resultant DCCPM is depicted in FIG. 5 b.

In a particularly preferred embodiment the linker may incorporate polyethylene glycol in single or multiple units (PEG)_(n), where n=1 to 10 PEG molecules.

Hereafter, where the CPP comprises the sequence RKF-S5-RLF-S5 (SEQ ID NO: 57) and the BFL is a PEGylated SMCC, the resultant compound is termed CP8M.

Where the CPP comprises the sequence RKF-S5-RLF-S5 (SEQ ID NO: 57) and the BFL is a PEGylated hydrazynal nicotinic acid (HNA), the resultant compound is termed HP8M.

Where the CPP comprises the sequence RKF-S5-RLF-S5 (SEQ ID NO: 57) and the BFL is SMCC, the resultant compound is termed CBM.

Thus a CPA, such as Compound III (FIG. 5 b ) may be covalently linked to a BFL, if required, preferentially incorporating (PEG)_(n) where n=1-10.

Covalent linkage to the CPP may be via, for example, but not limited to, a β-ala or any other suitable moiety.

In the preferred embodiment, the (PEG)_(n) is linked using a sulphur containing molecule e.g. cysteine, to enable covalent coupling as a PEGylated (SMCC). This in turn is covalently linked to a functional group on the BAC, in the preferred embodiment a primary amine, (Compound I), thus generating a DCCPM (Compound V).

According to a second aspect of the invention there is provided a method for facilitating the uptake of a biologically active compound (BAC) into a cell by the conjugation of the biologically active compound, directly or via a bi-functional linker (BFL), to a cell penetrating agent (CPA) which is a stabilized peptide which has a conformation imposed upon it by stapling to form a stapled peptide (StaP) or stitching to form a stitched peptide (StiP), to form a drug carrying cell penetrating molecule (DCCPM) and presenting said DCCPM to said cell in a suitable vehicle.

Where HNA has been incorporated into the terminal end of the CPP, to form a DCCPM in which the BAC is an ON, the ON has been modified to incorporate 4 formyl benzioic acid to facilitate covalent conjugation.

According to a third aspect of the present invention there is provided a DCCPM of the first aspect of the invention for use in the treatment of a disease requiring alteration of the expression of an endogenous or exogenous gene.

The DCCPM may be used in the treatment of a, for example, neuromuscular disease, metabolic disease, cancer, age-related degenerative disease or to treat an acquired viral infection.

In one embodiment the DCCPM is used in the treatment of a muscular dystrophy e.g. Duchenne muscular dystrophy (DMD) although the skilled person will readily appreciate that the invention can be used to target a wide range of genes.

In the case of DMD the DCCPM may comprise an AON targeting exon 51 of the dystrophin gene.

In accordance with a fourth aspect of the present invention there is provided a method of improving the bioavailability of a drug or BAC comprising linking the drug or BAC to a CPP which is a stabilized peptide which has a conformation imposed upon it by stapling to form a stapled peptide (StaP) or stitching to form a stitched peptide (StiP).

In accordance with a fifth aspect of the present invention there is provided a method of introducing a drug or BAC to a site which is refractory to a drug or BAC in its native state comprising linking the drug or BAC to a CPP which is a stabilized peptide which has a conformation imposed upon it by stapling to form a stapled peptide (StaP) or stitching to form a stitched peptide (StiP) and administering it to a subject.

The DCCPMs of the invention can be used to administer the drug or BAC to a target tissue, such as, for example the heart, brain or muscle.

In accordance with a sixth aspect of the present invention there is provided a method of treating a subject to alter the expression of an endogenous or exogenous gene comprising administering a DCCPM of the invention to a subject.

In accordance with a seventh aspect of the present invention there is provided a composition comprising a DCCPM of the invention and one or more pharmaceutically acceptable excipients enabling the composition to be administered orally, parenterally, intravenously or topically.

BRIEF DESCRIPTION OF THE DRAWINGS

Embodiments of the invention are further described hereinafter with reference to the accompanying Drawings, in which:

FIG. 1 a-c show a general schematic of a CPP which it has been stabilized by means of the incorporation of olefin-bearing α,α-di-substituted amino acids that permit a further chemical modification such that a cross link can be formed. Cross linking of two such non-natural amino acids is termed stapling; cross linking involving more than two non-natural amino acids is termed stitching. This schematic can be referenced against Tables 1 and 2 of this application.

FIG. 1 a is an example of a non-cyclised and an i,i+4 ring closing metathesis (RCM) using Grubb's Gen 1 catalyst to form an StaP CPA;

FIG. 1 b is an example of a reduced RCM StaP using conventional reduction chemistry;

FIG. 1 c is a schematic showing a selection of different StaP or StiP RCM configurations and their corresponding starting positions;

FIG. 2 exemplifies the structures of charge variants: 3+(CP8M-3), 2+(CP8M-2), 1+(CP8M-1) and 0+ (CP8M-0) illustrating relative positions of charge on the StaP, however the positions and charge can be varied in any permutation or combination;

FIG. 3 exemplifies the structure of an amino acid which can be incorporated into StaP or StiPs with varying functional groups as defined in Table 6. The functional groups can then be used for bio-conjugation;

FIG. 4 a is a representation of a RCM reaction to form a StaP;

FIG. 4 b shows the resulting CD spectrum of the StaP and non-cyclised stating peptide;

FIG. 4 c is a COSY NMR spectra of CP8M;

FIG. 4 d is a NOESY NMR Spectra of CP8M;

FIG. 4 e is a TOCSY NMR spectra of CP8M;

The Spectra were collected at room temperature in H₂O spiked with 10% D₂O and 10 mM sodium acetate;

FIG. 5 a is a schematic diagram of StaP DCCPM depicting variants of linkers and spacers as defined in Table 5;

FIG. 5 b is a schematic diagram of DCCPM depicting the synthetic steps for the conjugation of a StaP to a PMO. The PMO is modified to yield a 5′ amine group (compound I); the heterobifunctional protein crosslinker Succinimidyl-4-[N-maleimidomethyl] cyclohexane-1-carboxylate (SMCC; compound II) is attached to 5′ amine group to yield compound IV; an i,i+4 stapled peptide (compound III) is conjugated to generate the final DCCPM (compound V);

FIG. 5 c is a DCCPM of CP8M conjugated to an ON using a SMCC linker (e.g. PMO-CP8M);

FIG. 5 d is a DCCPM of HP8M using a HNA linker (PMO-HP8M);

The FITC group here and elsewhere may be any other fluorescent label and is present merely to enable visualization;

FIG. 6 shows a general schematic of a FITC labeled DCCPM in which the n-termini of the FITC labelled PMO (compound I) and the CPA (compound III) are linked via a bi-functional linker disuccinimidyl glutarate (DSG) forming compound VI;

FIG. 7 shows a general schematic diagram of a DCCPM in which a FITC labelled PMO is directly conjugated to a CPA through a shared nitrogen forming compound VII;

FIGS. 8 a-o show the liquid chromatography-mass spectrometry conformation of the synthetic steps and the molecular masses of compounds depicted in FIG. 1 , FIG. 2 and FIG. 5 . All PMOs in this application are fluorescently labelled unless specified otherwise.

FIG. 8 a is a LRMS(API-ES) mass spectra of CP8M-NC. Mass calculated for C₇₆H₁₃₀N₁₈O₁₆S²⁺ (M+2H)²⁺ 791.5 found 791.8;

FIG. 8 b is a LRMS(API-ES) mass spectra of CP8M. Mass calculated for C₇₄H₁₂₅N₁₈O₁₆S⁺ (M+H)⁺ 1554.9 found 1554.5;

FIG. 8 c is a LRMS(API-ES) mass spectra of CBM. Mass calculated for C₅₉H₉₅N₁₆O₁₀S⁺ (M+H)⁺ 1220.5 found 1220.1;

FIG. 8 d is a LRMS(API-ES) mass spectra of HP8M. Mass calculated for C₇₇H₁₂₅N₂₀O₁₆ ⁺ (M+H)⁺ 1586.9 found 1586.5;

FIG. 8 e is a HRMS(LQT-ESI) mass spectra of PMO. Mass calculated for C₃₃₂H₅₀₀N₁₅₃O₁₁₀P₂₅ (M) 9164.1675 found 9164.1882;

FIG. 8 f is a HRMS(LQT-ESI) mass spectra of PMO-SMCC. Mass calculated for C₃₄₄H₅₁₃N₁₅₄O₁₁₃P₂₅ (M) 9383.2570 found 9383.2704;

FIG. 8 g is a HRMS(LQT-ESI) mass spectra of PMO-CP8M. Mass calculated for C₄₁₈H₆₃₈N₁₇₂O₁₂₉P₂₅S⁺ (M+H)⁺ 10937.1806 found 10937.2377;

FIG. 8 h is a HRMS(LQT-ESI) mass spectra of NF-PMO-CP8M. Mass calculated for C₃₉₃H₆₁₉N₁₇₂O₁₂₁ P₂₅₅ (M) 10490.0372 found 10490.2268;

FIG. 8 i is a HRMS(LQT-ESI) mass spectra of PMO-HP8M. Mass calculated for C₄₁₇H₆₂₆N₁₇₃O₁₂₇P₂₅ (M) 10863.1285 found 10863.0716;

FIG. 8 j is a LRMS(API-ES) mass spectra of FITC 3+(CP8M-3). Mass calculated C₉₂H₁₃₂N₁₈O₂₀S²⁺ (M+2H)²⁺ 920.5 found 921.0;

FIG. 8 k is a LRMS(API-ES) mass spectra of FITC 2+(CP8M-2). Mass calculated C₉₂H₁₃₁N₁₇O₂₀S²⁺ (M+2H)²⁺ 913.0 found 913.6;

FIG. 8 l is a LRMS(API-ES) mass spectra of FITC 1+(CP8M-1). Mass calculated C₉₂H₁₂₉N₁₄O₂₀S⁺ (M+H)⁺ 1783.1 found 1782.6;

FIG. 8 m is a LRMS(API-ES) mass spectra of FITC+(CP8M-0). Mass calculated C₉₂H₁₂₆N₁₁O₂₀S⁻ (M−H)⁻ 1738.1 found 1738.0;

FIG. 8 n is a HRMS(LQT-ESI) mass spectra of PMO-4-FB. Mass calculated for C₃₄₀H₅₀₃N₁₅₃O₁₁₂P₂₅ ⁺ (M−H)⁺ 9295.1802 found 9295.2168; and

FIG. 8 o is a HRMS(LQT-ESI) mass spectra of PMO-CP8M-NC. Mass calculated for C₄₂₀H₆₄₂N₁₇₂O₁₂₉P₂₅S⁺ (M−H)⁺ 10965.2112 found 10965.2162;

FIGS. 9 a and 9 b demonstrate the comparative conjugation efficiencies of SMCC and HNA linker systems;

FIG. 9 a shows the % Conversion of HP8M and PMO-4FB into PMO-HP8M analysed by UV spectroscopy. % Conversion was calculated by A₃₅₀ of the bis-aryl hydrozone bond based on the starting reaction concentration of 705 μM. UV profiles of corresponding starting materials (HP8M and PMO-4FB) and the resulting conjugate (PMO-HP8M); and

FIG. 9 b shows the % isolated yield of PMO-CP8M and PMO-HP8M.

FIG. 10 a shows florescence microscopy images demonstrating a dose dependent increase in DCCPM delivery into a human osteosarcoma cell line (U2OS) maintained in culture, without transfection reagent. The biologically active compound was a PMO with a sequence:

SEQ ID NO 1: 5′GGCCAAACCTCGGCTTACCTGAAAT3′ (an antisense reagent targeted to exon 23 of the mouse dystrophin gene, that causes the exclusion of exon 23 during mRNA splicing maturation); the bi-functional linker was a PEGylated SMCC; and the StaP was RKF-S5-RLF-S5 (SEQ ID NO: 57). This configuration of DCCPM is depicted as PMO-CP8M in the subsequent figs; unconjugated PMO acts as a control. All compounds were added to U2OS cells maintained in culture, without transfection reagent for 4 hours;

FIG. 10 b is a graphical representation of the delivery of PMO and PMO-CP8M into a human osteosarcoma cell line (U2OS) maintained in culture without transfection reagent;

FIG. 11 is the analysis of PMO uptake into HEK293T cells by flow cytometry. Cells were incubated without PMO or with 1 μM PMO, 1 μM PMO-C8M or 1 μM PMO-CP8M-NC (all fluorescein-labelled) at 37° C. for 4 hours. Fluorescence was measured after washing the cells with PBS.

FIG. 12 a shows flow cytometry analysis of HEK293T cells treated with FITC+3 (CP8M3), FITC+2 (CP8M-2) and FITC+1 (CP8M-1) without transfection reagent for 4 hours;

FIG. 12 b shows flow cytometry analysis of HEK293T cells treated with FITC+3 (CP8M3), FITC+2 (CP8M-2) and FITC+1 (CP8M-1) without transfection reagent for 4 hours. The graph represents mean fluorescent intensity of FL1;

FIG. 13 shows fluorescence microscopy images either 5 μM PMO-CP8M or 5 μM PMO delivery into a mouse cell line that harbours the mdx mutation of the dystrophin gene (H2K mdx) maintained in culture, without transfection reagent, in which the PMO has a fluorescent label.

FIG. 14 shows an agarose gel electrophoresis image demonstrating that exon exclusion of the mouse dystrophin exon 23 is restricted to H2K mdx cells that have been transfected with 5 μM PMO-CP8M but not those treated with 5 μM PMO alone, in which the PMOs have a fluorescent label. 24 hours after incubation with PMO-CP8M or PMO, H2K mdx cells were recovered and RNA isolated. The RNA was reversed transcribed and an amplification between exon 20 and 26 of the mouse dystrophin gene, followed by a nested amplification between exon 20 and 26 was performed to yield a full length product of 901 bp fragment if exon 23 is present or 688 bp fragment if exon 23 is excluded;

FIG. 15 shows immuno-cytochemical staining for dystrophin from Tibialis anterior muscles of mdx mice following a single intramuscular injection of either 2.2 nmol PMO-CP8M or 2.2 nmol PMO into the Tibialis anterior muscle (dose in respect of molarity of PMO). Muscles were recovered 7 day post administration;

FIG. 16 shows a graphical representation of the number of skeletal muscle fibre being positive for an immuno-cytochemical staining for dystrophin from Tibialis anterior muscles of mdx mice injected with either 2.2 nmol PMO-CP8M or 2.2 nmol PMO. All dose are given in respect of the molarity of PMO;

FIGS. 17 a-d show immuno-cytochemical staining for dystrophin from skeletal muscles of mdx mice:

FIG. 17 a is from the diaphragm following a single intraperitoneal injection of 1 μmol/kg PMO-CP8M or 1 μmol/kg PMO [* denotes non fluorescent labelled PMO]. Muscles were recovered 7 days post administration;

FIG. 17 b is following multiple intravenous injections—total 4.4 μmol/kg PMO-CP8M or 4.4 μmol/kg PMO;

FIG. 17 c is following multiple intraperitoneal injections—total 10.9 μmol/kg PMO-CP8M or 10.9 μmol/kg PMO; and

FIG. 17 d is a graphical representation of the number of skeletal muscle fibre being positive for an immuno-cytochemical staining for dystrophin following intraperitoneal administration. All dose are given in respect of the molarity of PMO [* denotes non fluorescent labelled PMO]. Muscles were recovered 14 days post administration;

FIGS. 18 a-c show immuno-cytochemical staining for dystrophin from heart muscles;

FIG. 18 a is of mdx mice following a single intraperitoneal injection of 1 μmol/kg PMO-CP8M or 1 μmol/kg PMO. Muscles were recovered 7 days post administration;

FIG. 18 b is following multiple intraperitoneal injections—total 7.6 μmol/kg PMO-CP8M or 7.6 μmol/kg PMO. Muscles were recovered 14 days post administration;

FIG. 18 c is following multiple intraperitoneal injections—total 10.9 μmol/kg PMO-CP8M or 10.9 μmol/kg PMO;

FIG. 18 d is a graphical representation of the number of cardiac muscle fibre being positive for an immuno-cytochemical staining for dystrophin following a multiple intraperitoneal injections—total 7.6 μmol/kg PMO-CP8M or 7.6 μmol/kg PMO; and

FIG. 18 e is a graphical representation of the number of cardiac muscle fibre being positive for an immuno-cytochemical staining for dystrophin following multiple intraperitoneal injections—total 10.9 μmol/kg PMO-CP8M or 10.9 μmol/kg PMO. All dose are given in respect of the molarity of PMO [* denotes non fluorescent labelled PMO]. Hearts were recovered 14 days post administration;

FIG. 19 shows immuno-cytochemical staining for dystrophin from heart muscles of mdx mice following intraperitoneal injections of PMO-CP8M with a total cargo size of 8.7 KDa and PMO-CP8M with total cargo size of 9.2 KDa. Hearts were recovered 14 days post administration;

FIG. 20 shows immuno-cytochemical staining for dystrophin from the cerebellum of mdx mice following a single intraperitoneal injection of 1 μmol/kg PMO-CP8M or 1 μmol/kg PMO. All dose are given in respect of the molarity of PMO [* denotes non fluorescent labelled PMO]. Cerebella were recovered 7 days post administration; and

FIG. 21 demonstrates in vivo liver cell uptake of fluorescein-labelled PMO after intravenous administration of PMO or PMO-HP8M to mdx mice (single intravenous injection, 1 μmol/kg, analysed 2 weeks post-injection). Un-injected mdx mice were used as a negative control.

DETAILED DESCRIPTION

The invention is illustrated with reference to a single example which proves the benefit of the claimed invention.

An exemplary drug carrying cell penetrating molecule (DCCPM) was produced with a FITC label in order to demonstrate cellular uptake (Example 1).

The exemplary DCCPM comprises:

-   -   i) a biologically active compound (BAC)—(see Table 4 for         non-limiting examples);     -   ii) a cell penetrating agent (CPA) which is a stabilized peptide         (See Table 2 for non-limiting examples); and     -   iii) a bi-functional linker (BFL) (see Table 5 for non-limiting         examples).

The three components forming the DCCPM are described in more detail below, although as illustrated in FIG. 5 , the BAC and CPA can be linked directly (FIG. 6 ).

1. The Biologically Active Compound.

The biologically active compound is any compound that can exert a biological effect within a biological cell. Preferably, though not essentially, the BAC is one which will impact on the expression of one or more endogenous or exogenous genes. Examples include nucleic acids, DNAzymes, ribozymes, aptamers and pharmaceuticals. Preferred biologically active compounds for use in the present invention include electrically neutral oligonucleotides (charge −1 to +1 at physiological pH—about 7.5) such as polynucleic acids (PNAs) or PMOs or their modified derivatives that might impart a small electric charge (either positive or negative).

The biologically active compound may be used as a steric blocking compound to suppress or enhance: i) RNA splicing; ii) protein translation or iii) other nucleic acid:nucleic acid or nucleic acid:protein interactions, altering the gene expression of endogenous or exogenous (pathogen derived) genes.

The hybridisation of ON's to specific RNA sequence motifs prevents correct assembly of the spliceosome, so that it is unable to recognise the target exon(s) in the pre-mRNA and hence excludes these exon in the mature gene transcript. Exclusion of an in-frame exon can lead to a truncated yet functional gene product; exclusion of an out of frame exon results in a frame-shift of the transcript, potentially leading to a premature stop codon and a reduction in the target gene expression level.

Additionally, ON's can be designed to target 5′ translation initiation start sites of endogenous or viral gene transcript(s) to prevent binding of the translational machinery. Using ASO to suppress viral translation is a well-established technology and has progressed into clinical trials for viral haemorrhagic fevers such as Marburg and Ebola.

Also, ON can be designed to target 3′ untranslated region of an endogenous transcript that alters the stability of the transcript. Such targets include, and are not limited to, poly adenylation and/or cleavage sites of the transcript.

Also, ON can be designed to form aptamers such that the secondary and tertiary structures can bind proteins or other cellular targets thus impacting on specific gene expression levels.

Non-limiting exemplary ON chemistries are illustrated in Table 4.

In the non-limiting example illustrated, the target is exon 51 of the dystrophin gene and comprises the sequence:

SEQ ID NO 2: 5′CUCCAACAUCAAGGAAGAUGGCAUUUCUAG3′

2. The Cell Penetrating Agent (CPA) which is a Stabilized Peptide

The cell penetrating agents of the invention are stabilized peptides.

The peptides may be stabilized by stapling, to form a stapled peptide (StaP), or by stitching to form a stitched peptide (StiP)

All-hydrocarbon staples and stitches may confer a property, e.g. an α-helical structure, protease resistance, cellular penetrance, and biological activity.

Non-limiting examples of stapled and stitched peptide sequences are illustrated in Table 2 and include peptide sequences including S5, S8 and B5 (as defined in Table 2).

Stabilisation of e.g. the α-helical structure can be achieved by, for example, a ring-closing metathesis and may be catalysed by a variety of ruthenium catalysts including Grubbs generations 1 and 2 and Grubbs-Hoyveda generations 1 and 2.

All the peptide components (amino acids, unnatural amino acids, unstapled/unstitched, partially stapled/stitched and stapled/stitched peptides) may exist in specific geometric or stereoisomeric forms. All compounds include cis- and trans-isomers, (R)- and (S)-enantiomers, diastereoisomers and racemic mixtures thereof.

Preferred isomer/enantiomers will be enriched to give a greater proportion of one particular isomer or enantiomer. Embodiments thereof may be made of greater than 90%, 95%, 98% or 99%, by weight, of a preferred isomer/enantiomer.

Non-limiting examples of unnatural amino acids used in stabilising a peptide structure are illustrated in Table 1.

In one embodiment the applicant employs α,α-disubstituted unnatural amino acids bearing all-hydrocarbon tethers (e.g. α-methyl, α-pentenyl glycine).

For single turn stapling, one embodiment could employ a (S)-pentenylalanine (S5) at, e.g. i, i+4 positions, and in another embodiment, for double turn stapling, a combination of either R-octenylalanine/S-pentenylalanine (R8/S5) or S-octenylalanine/R-pentenylalanine (S8/R5) at e.g. i, i+7 positions can be used. The same pairings can be used to install more than one staple within a given peptide template. S5 can be substituted at i, B5 at position i+4 positions, and S8 can be been substituted at i, i+4, i+11 positions to generate stitched peptides. The S5 configured amino acid and its enantiomer R5, or S8 configured amino acid and its enantiomer R8, differ only in the opposite stereochemical configuration of the staple they bear.

Based upon the inclusion of a single or a double turn staple, peptides may comprise of one or more of the sequences in Table 2. Based upon the specific peptides shown in Table 2, a person skilled in the art can easily envisage peptides with 3, 4, 5 or more turn stabilising staples.

The hydrocarbon bridge may be composed of a double hydrocarbon bond or a single hydrocarbon bond.

In one embodiment the cell penetrating agent has a stitch or staple peptide comprising the sequence RFK-S5-RLF-S5 (SEQ ID NO: 57).

In another embodiment the peptide is a branched stapled peptide. The branched stapled peptide comprises of 2 or more chains of peptides. Branched peptides may be formed using any method know to the art; in one embodiment a lysine residue is used to branch two peptide chains.

Functional derivatives of disclosed peptide sequences could be used. Functional derivatives may have representative fragments or homologues or peptides that include insertions to the original peptide. Typical derivative would have 70%, 80%, 90% or more of the original peptide sequence and may have up to 200% of the number of amino acids of the original peptide. The derivatives would be used to enhance the delivery of a biologically active compound.

Peptide sequence can include modified amino acids to include functional groups that permit the addition of other moieties. Non-limiting examples of such moieties include an acetyl, a cholesterol, a fatty acid, a polyethylene glycol, a polysaccharide, an aminoglycan, a glycolipid, a polyphenol, a nuclear localising signal, a nuclear export signal, an antibody and a targeting molecule.

3. Bi-Functional Linker

A bi-functional linker may be used to link the BAC to the CPA.

Preferred linkers will link between, for example, an amine group on the BAC and a sulfhydryl (thiol) group (usually a cysteine residue) on the CPA terminus. Examples of substrates to achieve this include, but are not limited to, SMCC (succinimidyl 4-(N-maleimidomethyl)cyclohexane-1-carboxylate), AMAS (N-α-maleimidoacet-oxysuccinimide ester, BMPS (N-β-maleimidopropyl-oxysuccinimide ester), GMBS (N-γ-aleimidobutyryl-oxysuccinimide ester), DMVS (N-δ-maleimidovaleryl-oxysuccinimide ester, EMCS (N-ε-malemidocaproyl-oxysuccinimide ester), and LC-SMCC (Succinimidyl 4-(N-maleimidomethyl)cyclohexane-1-carboxy-(6-amidocaproate) as exemplified in Table 5.

Another preferred linker system is hydrazynal nicotinic acid (HNA), however if the BAC is a PMO, the PMO is modified to incorporate 4 formyl benzioic acid.

Other linkers such as DSG (disuccinimidyl gluterate) and DSCDS (disuccinimidyl-cyclohexl-1,4-diester) will include the ability to link the 5′-amino group of the BAC to the N-terminus of the CPA (Table 5, entries 8 and 9).

Linkers may include other elements that confer a desirable property on the DCCPM e.g. spacer between ON and CPA or an element that will enhance solubility, for example a PEGylated element as illustrated in FIGS. 5 c and 5 d . Non-limiting examples are shown in Table 5.

The biologically active compound is covalently attached to the chimeric cell delivery peptide. Again, this can be done using any method known in the art. Preferably, the cell delivery peptide is attached to the biologically active compound by means of a disulphide bridge or a thiol maleimide linker e.g. SMCC; the attachment may be by means of an amide linker or an oxime linker or a thioether linker.

EXAMPLE 1: (PROOF OF PRINCIPLE)

DCCPM to Enhance RNA Steric Blocking in Treating Duchenne Muscular Dystrophy (DMD).

Introduction

Duchenne muscular dystrophy (DMD) is the most common inherited lethal childhood disease in the world, with a worldwide incidence of approximately 1 in 4000 live births³³. This severe muscle-wasting disorder is caused in the majority of families by gene mutations leading to disruption of the reading frame and premature truncation of the protein dystrophin^(34,35).

RNA splicing suppression of the DMD transcript has particular promise. The hybridisation of ASOs to specific RNA sequence motifs prevents correct assembly of the spliceosome, so that it is unable to recognise the target exon(s) in the pre-mRNA and hence excludes them in the mature gene transcript. ASO-mediated RNA splicing suppression resulting in the re-expression of a truncated, yet functional dystrophin protein has been demonstrated in vitro and in the pre-clinical mdx mouse model^(29,36-41), which led to clinical development programs^(8,13).

Although intravenously administered PMOs have demonstrated a dose-dependent increase in dystrophin re-expression with some functional benefit^(13,42), skeletal muscle dystrophin restoration is still very variable between patients after many multiple administrations. Importantly, many other target tissues (e.g. brain and heart) remain refractory to PMO transfection even when repeat administration or high dose strategies are employed²⁷⁻²⁹.

To date unmodified CPA conjugation improves PMO bio-distribution and serum stability³⁰⁻³², however toxicity is still a major roadblock for pipeline development¹⁹.

Applicant hypothesised that a CPA based upon a stabilized e.g. StaP (or StiP) conjugated to a PMO known to cause RNA splicing suppression of the DMD transcript, would lead to a greater level of dystrophin restoration and re-expression of dystrophin in tissues refractory to naked PMO without the potential for CPA related toxicity.

Materials and Methods

Nuclear Magnetic Resonance (NMR) Analysis of StaP

¹H NMR spectra was recorded using a Bruker Avance III 500 (500 MHz) spectrometer. Samples were dissolved in H₂O with 10% D₂O and 10 mM sodium acetate.

NOESY spectra were recorded with a 12626.263 Hz sweep width, 4096 complex points (DQD acquisition mode) in the direct dimension and 1024 indirect points (States-TPPI acquisition mode). A NOESY mixing time of 250 ms was used to provide cross peaks with high signal to noise while largely avoiding spin diffusion. A pre-saturation pulse on water and a 3-9-19 pulse sequence with 20% Z-gradients (4,5) aided solvent suppression. TOCSY spectra were recorded with the same spectral width and resolution as the NOESY with a homonuclear Hartman-Hahn transfer using the MLEV17 sequence for an 80 ms mixing time (6). Two power levels were used for excitation (3 dB) and spinlock (12.2 dB). Water suppression was achieved as with the NOESY.

High Resolution Mass Spectroscopy

High-resolution mass spectra were recorded on a Thermo scientific LQT Orbitrap XL under electron spray ionization conditions (ESI) or where indicated under Atomospheric Pressure Ionisation (API) condition.

Circular Dichroism (CD) Spectroscopy

CD analysis was performed on an Applied Photophysics Chirascan Circular Dichroism spectrometer. Samples were dissolved in D₂O at 0.125 W/W % and data acquired in triplicate at room temperature and subsequently averaged and smoothed using built in qCD software. Graphs were plotted by subtracting a blank D₂O spectrum from the acquired data to provided blank correction.

Synthesis of PMO-CP8M and NF-PMO-CP8M

PMO (22.2 mg, 2.1 μM) was dissolved in PBS (400 μL, 1×) and incubated at room temp after the addition of SMCC linker (6 mg, 18 μM, 9× excess) dissolved in MeCN 100 μL. After 45 mins the mixture was desalted using sephadex g25 hydrated in a PBS 1× and was also used as the eluent. RCM-C-PEG-8Mer (3 mg, 2.5 μM) was mixed immobilised TCEP (750 μL) for 1 h. The SMCC modified PMO was then desalted into PBS/MeCN (500 μL 4:1) and immediately the peptide was eluted from the immobilised TCEP and stirred at room temp for 3 hours before purification on a Waters HLB column.

The solution was loaded onto 4 HLB columns, and washed with milliQ water to remove any salts then 20% MeCN in water and finally PMO-CP8M was removed with 50% MeCN in water. The MeCN content was reduced by rotary evaporation and the conjugate subsequently freeze dried to yield the final lipholysed compound.

Synthesis of PMO-HP8M

Modification of PMO to PMO-4FB.

4-FB (250 mg, 1.5 mM) was dissolved in DMF with COMU (1.2 g, 2.6 mM) and NHS (230 mg, 2.0 mM) and stirred for a few mins. Nb, 4-FB did not fully dissolve until DIEA was added. DIEA (0.54 mL 3.0 mM) was then added upon which the reaction mixture changed from colourless to pale yellow/orange. The reaction mixture was stirred for 1 h and monitored by TLC using 5% MeOH in DCM. The mixture was separated over DCM to remove DMF then purified by flash chromatography using DMC to elute the top spot staining positive with 2,4 DNP. Product was collected as an off white solid 112 mg (30%).

PMO (30.4 mg, 3 μM) was added to a solution of 4-FB and dissolved in Carbonate buffer:MeCN (50% MeCN) and NHS activated 4-FB (10 mg, 32 μM) was added and stirred overnight. The mixture was then desalted using sephadex G25 superfine with water:MeCN as an eluent. MeCN was removed by rotary evaporation and the remaining eluent was then freeze dried. Freeze dried product yielded 24 mg 83% yield.

Conjugation of PMO-4FB to HP8M

HP8M was dissolved in milliq ultra pure water (100 μL) to give a solution of 12 mg/mL. Aldehyde modified PMO (7 mg, 0.76 μM) was dissolved in water/MeCN (300 μL, 1:1) and desalted using sephadex G25 superfine and water/MeCN (1:1) as the eluent. The collected fraction was then diluted to 1 mL total volume in water:MeCN mix (1:1) and PMO content was analysed by UV/vis and found to be 6.5 mg/mL or 705 μM. HNA peptide and Analine (10 mM final conc) was then added and UV/vis monitored for evidence of A₃₅₄ and used to calculate the conjugation of PMO to peptide.

PMO and Peptide Synthesis

PMO were synthesised with a 5′ amine group and 3′ fluorescein isothiocyanate (FITC) label and purified >90% by Genetool LLC (Philomath, Oreg. USA). All peptides were synthesized following an established protocol using standard Fmoc-peptide chemistry on Rink amide MBHA resin. The coupling reactions were performed by the addition of a mixture of 10 equivalents of the amino acids, 9.9 equivalents of HCTU and 20 equivalents of DIPEA in NMP (equivalents relative to initial loading of Rink amide MBHA resin). The reactions were allowed to proceed for at least one hour. Coupling of non-natural amino acids (R/S5, R/S8 or B5) was performed with 4 equivalents of the amino acid, 3.9 equivalents of HCTU and 10 equivalents of DIPEA in NMP for two hours. The ring closing metathesis reaction of the olefin-containing non-natural amino acids was facilitated with Grubbs I catalyst (benzylidene-bis(tricyclohexylphosphine)-dichlororuthenium) dissolved to approximately 10 mg/mL in 1,2-dichloroethane (DCE) for two hours under nitrogen bubbling. Subsequently, excess catalyst was washed from the resin with DCE and then coupled with an N-terminal FITC. Upon completion, peptides were simultaneously cleaved from the resin and de-protected using a cleavage cocktail containing 95% TFA, 2.5% TIS and 2.5% water. Crude peptides were dissolved in 50% acetonitrile/water, passed through a 0.2 μm syringe filter, and purified by reverse phase HPLC using a C-18 column (Agilent, Palo Alto, Calif.). Compound identification and purity was assessed using coupled LC/MS (Agilent, Palo Alto, Calif.). Purified fractions were pooled and evaporated to remove acetonitrile and trace TFA by Speedvac and then lyophilized to dryness. A non-ring closed peptide was also produced as a control.

Cell Culture and Transfection

U2OS cells (Human osteosarcoma) were cultured in high glucose DMEM supplemented with 10% foetal calf serum (Sigma, UK) at 37° C. under an 8% CO2/92% air atmosphere.

H₂K mdx mouse myoblasts were cultured at 33° C. under a 8% CO₂/92% air atmosphere in high-glucose DMEM supplemented with 20% foetal calf serum, 0.5% chicken embryo extract (PAA laboratories Ltd, Yeovil, UK), and 20 units/ml γ-interferon (Roche applied science, Penzberg, Germany). Cells were then treated with trypsin and plated at 8×10⁴/cm² in 24-well plates coated with 0.1 mg/ml ECM gel (Sigma). H₂K mdx cells were transfected 24 h after seeding with treatment in a final volume of 0.2 ml of normal growth media. Following 4 hours of transfection, the PMO or PMO-SAP was removed and replaced with DMEM supplemented with 5% horse serum. Fluorescence and RNA extraction was performed 48 hours post transfection.

HEK293T cells (Human embryonic kidney) were cultured in high glucose DMEM supplemented with 10% foetal calf serum (Sigma, UK) at 37° C. under an 8% CO₂/92% air atmosphere.

U2OS cells were incubated with PMO or PMO-CP8M at increasing concentration (0.5 μM, 1.0 μM, 5.0 μM and 10 μM) with any facilitation transfection reagent; H₂K mdx mouse myoblasts were incubated with PMO or PMO-CP8M at 5.0 μM: HEK293T cells were incubated with CP8M (1.0 μM, 10 μM and 100 μM) and PMO, PMO-CP8M-NC, PMO-C8M at 1.0 μM. Levels of fluorescence was quantified at 494 nm to determine relative entry of respective compounds by microscopic or flow cytometry methodologies.

RNA Extraction and Nested RT-PCR Analysis

Total RNA was isolated from H₂K mdx mouse myoblasts cells (RNeasy, Qiagen, UK). The RNA was reversed transcribed (nanoscript2, Primer Design UK) and an amplification between exons 20 and 26, followed by a nested amplification between exon 20 and 26 was performed to yield a full length product of 901 bp or 688 bp if the mouse dystrophin exon 23 was excluded. Products loaded in a 1% agarose gel (buffered with tris acetate 40 mM and 1 mM ethylenediaminetetraacetic acid).

Animals

mdx mice, with access to chow and water ad libitum, were used in all experiments. All experiments were carried out in the Animal unit, School of Biological Science, University of Reading, Reading, UK according to procedures authorized by the UK Home Office. Mice were killed by CO₂ inhalation or cervical dislocation at desired time points, and muscles and other tissues were snap-frozen in liquid nitrogen-cooled isopentane and stored at −80° C.

Administration of PMO or PMO-CP8M

Intramuscular administrations: Tibialis anterior muscles of mdx mice were injected with either 2.2 nmol PMO or 2.2 nmol PMO-CP8M under isoflurane anaesthesia. Systemic administration: mdx mice were subject to a single or repeated intraperitoneal injections of PMO or PMO-CP8M (or non-fluorescently labelled variants) at doses ranging from 1 μmol/kg to 10.9 μmol/kg total delivery; alternatively, mdx mice were subject to single or repeated intravascular injections of PMO or PMO-CP8M ranging from 1 μmol/kg to 4.4 μmol/kg total. A series of tissues were recovered at the end of the experiment that included skeletal muscle, heart, brain and liver.

Histology and Immuno-Cytochemistry

For skeletal muscle, heart and brain, 10 μM cryosections were cut and dystrophin protein was detected using rabbit polyclonal antibody to dystrophin (ab15277; Abcam, Cambridge, UK). Routine haematoxylin and eosin staining was used to assess general pathology and morphology. For liver, 10 μM cryosections were dried and embedded in fluorescence-compatible mounting medium (Dako), and general fluorescence was assessed microscopically at 494 nm.

Flow Cytometry

Uptake of fluorescently-labelled PMO was determined by flow cytometry using an Accuri C6 flow cytometer. PMO-transfected cells were released with trypsin, washed in PBS and kept on ice before analysis. Cell fluorescence in single live cells was determined using FlowJo software after appropriate gating. Untreated cells were used to establish gating settings for the determination of the % fluorescein-positive cells.

Statistical Analysis

All data are reported as mean values ±SEM. Statistical differences between treatment groups and control groups were evaluated by SigmaStat (Systat Software, UK) and student's t test was applied. Significance was accepted for p-values<0.05.

Results

Circular dichroism and the nuclear magnetic resonance data confirmed that the ordered structure of the peptides was as expected and that the stapled peptides adopted an α-helical structure (FIG. 4 ).

The conjugation of PMO-SMCC with a CPP to form PMO-CP8M has consistently yielded an efficiency of 10%. Surprisingly, adopting a conjugation based upon a PMO modified to incorporate 4 formyl benzioic acid and hydrazynal nicotinic acid (HNA) incorporated into the terminal end of the CPP, increased the efficiency of conjugation to yield PMO-HP8M at 59% (FIG. 9 ).

PMO was conjugated to the bi-functional linker (a PEGylated SMCC) and a CPP (RKF-S5-RLF-S5 (SEQ ID NO: 57)) as confirmed by mass spectrometry (FIG. 7 ). Subsequently PMO and PMO-CP8M were transfected into a standard cell line (U2OS) to determine if the CP8M conferred enhanced cell entry to the cell. Naked PMO were refractory to cell entry, giving only a background fluorescence signal, compared to a dose dependent increase in fluorescence with PMO-CP8M (FIGS. 10 a and 10 b ). The lack of signal above background does not allow statistical analyses of the comparative increase in fluorescence, but clearly demonstrated that without the CP8M conjugation, PMO did not enter the cell.

Transfection experiments conducted in the HEK293T human embryonic kidney cells again demonstrated that PMO was refractory to cell entry. Importantly, a non-ring closed variant of CP8M (termed CP8M-NC) also did not result in significant cell entry above that of PMO alone. However a ring closed variant that contains the core sequence RKF-S5-RLF-S5 (SEQ ID NO: 57) demonstrated that when conjugated to a fluorescently labelled PMO (to form PMO-C8M), that the PMO was now efficiently taken into cells (FIG. 11 ). This confirms that the shape imposed upon the peptide sequence, following a ring closing metathesis, is important to facilitate cellular entry of a DCCPM in which the BAC is an ON, more specifically a PMO.

The formal charge of CP8M is +3 at physiological pH. We also provide data demonstrating that reducing the formal charge within this sequence still leads to a surprising and significant cellular entry of CP8M variants with formal charges of +2 (CP8M-2) and +1 (CP8M-1) (FIGS. 12 a and 12 b ), particularly at lower concentrations. The reduction in charge leads to solubility issues which account for the failure of a dose dependent increase, unlike that observed with CP8M. Alternative excipients or manipulations of the peptide as highlighted in Table 5 and Table 6 are likely to overcome these solubility issues.

When transfection experiments were conducted in the H₂K mdx mouse myoblasts cells, it confirmed the finding that PMO are refractory to muscle cell entry, which was overcome with the conjugation of CP8M (FIG. 13 ) and that the CP8M mediated delivery of PMO resulted in the steric blockade of RNA editing of the dystrophin transcript, such that exon 23 was excluded from the transcript (FIG. 14 ). Again, the lack of exon exclusion from the PMO only samples precludes comparative statistical analyses; but highlights that exon exclusion, resultant from entry of a PMO, only occurs when the PMO is conjugated to CP8M.

In order to determine if CP8M hindered the biological activity of the PMO, direct intramuscular administrations (2.2 nmol) were conducted into the Tibialis anterior muscle of mdx female mice, with muscle recovered 7 days post-administration. The percentage of dystrophin re-expression was equivocal between the PMO-CP8M (805.75) and the naked PMO (762.25) with no statistical significant difference (n=4, p=0.863; FIG. 15 and FIG. 16 ). Thus it was determined that CP8M does not confer any steric hindrance to the biological activity of the PMO.

Systemic administrations of PMO-CP8M and PMO were conducted in mdx mice to determine if the CP8M moiety enhanced cell entry into skeletal muscle. Varying sub-optimal amounts (totally 1 μmol/kg, 4.4 μmol/kg, 10.9 μmol/kg) were administered by either intraperitoneal or intravenous injections, and diaphragm and/or Tibialis anterior (TA) muscle recovered 7 days post-administration. After a single intraperitoneal administration of 1 μmol/kg the diaphragm muscle gave more dystrophin positive fibres after PMO-CP8M treatment compared to the PMO control group (FIG. 17 a , n=1). In tibialis anterior muscles, intravenous (4.4 μmol/kg; n=3) data was equivocal between groups (FIG. 17 b and FIG. 17 d , p=0.201), as was the intraperitoneal (10.9 μmol/kg; n=4) data (FIG. 17 c and FIG. 17 d , p=0.886).

(4.4 μmol/kg; n=3) data was equivocal between group (FIG. 17 b and FIG. 17 d , p=0.201), as was the intraperitoneal (10.9 μmol/kg; n=4) data (FIG. 17 c and FIG. 17 d , p=0.886).

Systemic intraperitoneal administrations of PMO-CP8M and PMO were conducted in mdx mice to determine if CP8M enhanced cell entry (FIGS. 18-21 ). A series of tissues was recovered and frozen 1 or 2 weeks post-administration (skeletal muscle, heart, brain and liver).

A single low dose of PMO or PMO-CP8M (1 μmol/kg) was administered (n=1 per group) and tissues recovered 7 days post-administration. Dystrophin-positive heart muscle fibres were detected after PMO-CPM8, but not PMO administration (FIG. 18 a ).

In addition, we carried out repeated intraperitoneal administrations into mdx mice. Intraperitoneal injections of PMO-CP8M (without fluorescent label) totaling 7.6 μmol/kg over 4 days (n=4 per group) lead to a significant increase in dystrophin-positive heart muscle fibres 2 weeks post-administration compared to injection of an equimolar amount of PMO (340±69 vs 57±17 fibres, p<0.01; FIGS. 18 b & 18 d).

Furthermore, Applicant carried out intraperitoneal administration of PMO or PMO-CP8M, totalling 10.9 μmol/kg over 2 days (n=4 per group). Again, administration of PMO-CP8M lead to a significantly higher number of dystrophin-positive heart muscle fibres compared to administration of PMO (680±163 vs 33±8 fibres, p<0.05; FIGS. 18 c & 18 e).

PMO-peptide conjugates of both 8.7 kDa and 9.2 kDa were successfully delivered to heart muscle fibres as evidenced by the induction of dystrophin re-expression in the hearts of mdx mice (FIG. 19 , n=4).

A single low dose (1 μmol/kg) intravenous administration of PMO-CP8M, but not PMO (both without fluorescent label), led to recovery of dystrophin expression in the Purkinje cells of mdx mouse cerebellum (FIG. 20 ; n=1 per group). No dystrophin expression was observed in the PMO control.

A single low dose (1 μmol/kg) intravenous administration of PMO-HP8M led to increased hepatocyte fluorescence in the vicinity of blood vessels two weeks post-administration compared to administration of PMO (FIG. 21 ; n=1 per group), implying increased uptake of PMO-HP8M in hepatocytes.

Conclusion

From the data generated it can be seen that the conjugation of a CPA, stabilized by stapling, to a BAC (in the form of a PMO), via a BFL, facilitates entry of the PMO into a cell. The StaP CPA facilitated PMO entry in both in vitro and in vivo assay systems.

Applicant's data presents evidence that modified linker systems based on HNA and 4 formyl benzioic acid improve the efficiency of conjugation between a BAC and CPA.

Surprisingly, variants of CPA in which the formal charge is reduced demonstrate enhanced cell entry at lower concentrations. This will have important sequelae with respect to improving the toxicological profile of CPA, more specifically a CPP.

The in vivo model of RNA splicing suppression demonstrated that the biological action of an α-helical peptide conjugated PMO is equivalent to naked PMO following intramuscular administration, thus determining that no steric hindrance is exerted upon the PMO when coupled to an α-helical peptide moiety.

The data demonstrates the fact that in the in vivo model of RNA splicing suppression the stabilized CPA may enhance cell entry into skeletal muscle, particularly at lower doses. However PMO are known to enter skeletal muscle without a CPP conjugation.

Surprisingly, and very significantly, it has been demonstrated that tissues refractory to naked PMO transfection re-express dystrophin protein in both the heart and brain (purkinje cell) compartments when the PMO is conjugated with a StaP.

Applicant further provides evidence that the CPP can facilitate the entry of cargoes of different size and mass far beyond that stated in the current state of the art.

The repertoire of human and animal diseases that can be addressed is now expanded and enhanced due to the increased pharmacodynamics of the PMOs when conjugated with a stabilised peptide. Neuromuscular disease, metabolic disease, cancer, age-related degenerative diseases and acquired viral infection can all be targeted.

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The invention claimed is:
 1. A molecule comprising: i. a biologically active siRNA or antisense oligonucleotide moiety, comprising a phosphorodiamidate morpholino oligonucleotide (PMO) covalently linked via a bi-functional linker moiety (BFL) to, ii. a peptide moiety comprising a stapled peptide (StaP) or a stitched peptide (StiP), wherein the StaP or StiP, is a stabilized peptide which has a conformation comprising at least one alpha helix by olefin cross linking comprising in the StaP an olefin cross link between two unnatural amino acids of the peptide at positions i, i+4, and/or i, i+7 and in the StiP at least two olefin cross links between at least three unnatural amino acids of the peptide at positions i, i+4, and i+11, and the StaP or the StiP can penetrate a cell membrane and has the amino acid sequence comprising SEQ ID NO: 29, 30, 35, 43, 46, 61, 92, 93, 94, 95, 96, 97, 98, 113, 120, 151, 152, 175, 176, 177, 178, 180, 181, 182, 183, or 184, and wherein the molecule can penetrate a cell membrane, and has biological activity of the oligonucleotide moiety.
 2. The molecule according to claim 1, wherein the StaP or StiP comprises at least two unnatural amino acids bearing all-hydrocarbon tethers and at least one of those unnatural amino acids has an α-methyl group.
 3. The molecule according to claim 1, wherein each cross link is formed by ring-closing olefin metathesis.
 4. The molecule according to claim 1, wherein each cross link comprises a hydrocarbon bridge, and wherein at least one cross linked unnatural amino acid comprises an a-methyl group.
 5. The molecule according to claim 1, wherein the StaP or StiP comprises at least two unnatural amino acids bearing all-hydrocarbon tethers.
 6. The molecule of claim 5, wherein the StaP or StiP is stabilized by at least one cross link between the unnatural amino acid R-octenylalanine and the unnatural amino acid S-pentenylalanine.
 7. The molecule according to claim 3, wherein the StaP or StiP is stabilized by at least one cross link between one or more of the unnatural amino acids: (S)-pentenylalanine (S5) or its enantiomer (R5); S-octenylalanine (S8) or its enantiomer (R8); or combinations thereof.
 8. The molecule according to claim 1, wherein the StaP or StiP is stabilized by at least one cross link between one or more of the unnatural amino acids:

wherein S5 is (S)-pentenylalanine, R5 is (R)-pentenylalanine, S8 is (S)-octenylalanine, R8 is (R)-octenylalanine, B5 is α, α-di-substituted pentenylalanine, B8 is α, α-di-substituted octenylalanine, and S-OAS and R-OAS are 0-allylserine analogues.
 9. The molecule according to claim 5, wherein the StaP or StiP is stabilized by at least one cross link the unnatural amino acid R-octenylalanine and the unnatural amino acid R-pentenylalanine.
 10. The compound according to claim 1, wherein the stabilized conformation comprises at least one beta sheet.
 11. The molecule of claim 1, wherein the BFL comprises:

a residue of succinimidyl 4-(N-maleimidomethyl) cyclohexane-l-carboxylate, where Z is

and Y is a covalent bond to the N-terminus of the StP or the StiP, or Y is

where n is 1 to 10;

a residue of N-α-maleimidoacet-oxysuccinimide ester, where Z is

and Y is a covalent bond to the N-terminus of the StaP or the StiP, or Y is

where n is 1 to 10;

a residue of N-β-maleimidopropyl-oxysuccinimide ester, where Z is

and Y is a covalent bond to the N-terminus of the StaP or the StiP, or Y is

where n is 1 to 10;

a residue of N-γ-aleimidobutyryl-oxysuccinimide ester, where Z is

and Y is a covalent bond to the N-terminus of the StaP or the StiP, or Y is

where n is 1 to 10;

a residue of N-δ-maleimidovaleryl-oxysuccinimide ester, where Z is

and Y is a covalent bond to the N-terminus of the StaP or the StiP, or Y is

where n is 1 to 10;

a residue of N-ϵ-malemidocaproyl-oxysuccinimide ester, where Z is

and Y is a covalent bond to the N-terminus of the StaP or the StiP, or Y is

where n is 1 to 10

a residue of succinimidyl 4-(N-maleimidomethyl) cyclohexane-l-carboxy-(6-amidocaproate), where Z is

and Y is a covalent bond to the N-terminus of the StaP or the StiP, or Y is

where n is 1 to 10;

a residue of succinimidyl 4-(N-maleimidomethyl) cyclohexane-l-carboxylate (polyethylene glycol), wherein n equals 1 to 10, Z is

and, Y is either present or not present, and when Y is present, Y is

where n is 1 to 10, and when Y is not present, Y is a covalent bond to the N-terminus of the StaP or the StiP;

a residue of disuccinimidyl gluterate, where Z is not present, and instead there is a covalent bond to the N-terminus of the StaP or the StiP, or to the N of

wherein n is 1 to 10; or,

a residue of disuccinimidyl-cyclohexl-1,4-diester, where Z is not present, and instead there is a covalent bond to the N-terminus of the StaP or the StiP, or to the N of

wherein n is 1 to
 10. 12. The molecule of claim 11, wherein in each Y moiety, n is
 5. 13. The molecule of claim 11, wherein the BFL comprises SMCC.
 14. The molecule of claim 1, wherein the BFL comprises:

a residue of succinimidyl 4-(N-maleimidomethyl) cyclohexane-l-carboxylate, where Z is

and Y is a covalent bond to the N-terminus of the StaP or the StiP;

a residue of N-a-maleimidoacet-oxysuccinimide ester, where Z is

and Y is a covalent bond to the N-terminus of the StaP or the StiP;

a residue of N-β-maleimidopropyl-oxysuccinimide ester, where Z is

and Y is a covalent bond to the N-terminus of the StaP or the StiP;

a residue of N-γ-aleimidobutyryl-oxysuccinimide ester, where Z is

and Y is a covalent bond to the N-terminus of the StaP or the StiP;

a residue of N-δ-maleimidovaleryl-oxysuccinimide ester, where Z is

and Y is a covalent bond to the N-terminus of the StaP or the StiP;

a residue of N-ϵc-malemidocaproyl-oxysuccinimide ester, where Z is

and Y is a covalent bond to the N-terminus of the StaP or the StiP;

a residue of succinimidyl 4-(N-maleimidomethyl) cyclohexane-1-carboxy-(6-amidocaproate), where Z is

and Y is a covalent bond to the N-terminus of the StaP or the StiP;

a residue of disuccinimidyl gluterate, where Z is not present; or,

a residue of disuccinimidyl-cyclohexl-1,4-diester, where Z is not present.
 15. The molecule of claim 12, wherein the BFL comprises SMCC.
 16. The molecule of claim 15, wherein the oligonucleotide comprises 5′CUCCAACAUCAAGGAAGAUGGCAUUUCUAG3′ (SEQ ID NO:2).
 17. The molecule of claim 1, wherein the oligonucleotide comprises 5′CUCCAACAUCAAGGAAGAUGGCAUUUCUAG3′ (SEQ ID NO:2).
 18. The molecule of claim 1 wherein the StaP or the StiP has the amino acid sequence comprising SEQ ID NO: 43, 46, 61, 92, 93, 94, 95, 96, 97, 98, 151 or
 152. 19. The molecule of claim 17, wherein the StiP or StaP comprises pentenylalanine.
 20. The molecule of claim 16, wherein the StiP or StaP comprises pentenylalanine.
 21. The molecule according to claim 1, wherein the BFL comprises a residue of an amine to sulphydryl cross linker containing N-hydroxysuccinimide esters and malemide reactive groups separated by a cyclohexane spacer.
 22. The molecule according to claim 1, wherein the oligonucleotide moiety comprises RNA.
 23. The molecule according to claim 19, wherein the BFL comprises a residue of succinimidyl 4-(N-maleimidomethyl) cyclohexane-1-carboxylate (SMCC).
 24. The molecule of claim 21, wherein the oligonucleotide comprises 5′CUCCAACAUCAAGGAAGAUGGCAUUUCUAG3′ (SEQ ID NO:2).
 25. A composition comprising the molecule according to claim 1 and one or more pharmaceutically acceptable excipients.
 26. The molecule of claim 18 wherein the oligonucleotide comprises SEQ ID NO:1 or SEQ ID NO:2, and StaP or the StiP has the amino acid sequence comprising SEQ ID NO:
 61. 27. A composition comprising the molecule according to claim 17 and one or more pharmaceutically acceptable excipients.
 28. A composition comprising the molecule according to claim 18 and one or more pharmaceutically acceptable excipients.
 29. A composition comprising the molecule according to claim 23 and one or more pharmaceutically acceptable excipients.
 30. The composition of claim 29, formulated for oral, parenteral, intravenous, or topical administration. 